Provider Demographics
NPI:1265589139
Name:NICK, ALPA M (MD)
Entity type:Individual
Prefix:
First Name:ALPA
Middle Name:M
Last Name:NICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:925 GESSNER RD STE 550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2843
Practice Address - Country:US
Practice Address - Phone:713-467-1722
Practice Address - Fax:713-467-1704
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN54034207VX0201X
TXN2216207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ020218Medicaid
KY7100506970Medicaid